Article record

自动化纯音测听（PTA）在儿科人群听力损失评估中的应用：诊断准确性研究的系统评价与荟萃分析。

Automated pure tone audiometry (PTA) in the assessment of hearing loss in pediatric populations: A systematic review and meta-analysis of diagnostic test accuracy studies.

综述 Meta耳科IF 1.7Q2

文献信息

PMID	42830011
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Reem Hasan Alzubaidi 查看其他 10 位作者 Ali Almania；Suhayb Waleed Alamri；Hamoud A Bannan；Atheer Khalaf Alanazi；Muath Hamad Alqesair；Abdullah Hamid Taher；Lama Mohammed Alruwaili；Ali Mohammed Alqarni；Sarah Mhammed Alsharif；Meshael M Alkusayer
作者单位	College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia. Electronic address: reemhaalzubaidi123@gmail.com. 查看其他 9 条单位信息 Department of Otorhinolaryngology-Head and Neck Surgery, King Fahad Medical City, Riyadh, Saudi Arabia.；College of Medicine, Taibah University, Medina, Saudi Arabia.；College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.；College of Medicine, Tabuk University, Tabuk, Saudi Arabia.；Medical School, University of Szeged Albert Szent-Györgyi, Szeged, Hungary.；College of Medicine, Jouf University, Skaka, Saudi Arabia.；Prison Health Services, Ministry of Interior, Riyadh, Saudi Arabia.；King Abdulaziz Specialist Hospital, Taif Health Cluster, Saudi Arabia.；Pediatric Otorhinolaryngology and Airway Surgery, KSMC, Riyadh, Saudi Arabia.
期刊	International journal of pediatric otorhinolaryngology
SCI 分区	Q2
IF	1.7
研究类型	综述 Meta · 临床
所属专科	耳科

中文摘要

背景： 儿童期听力损失严重延迟儿童的正常发育。虽然传统纯音测听（PTA）是金标准，但它面临后勤障碍、专家短缺和高成本问题。基于智能手机的自动化测试通过使非专业人员能够进行远程、任务转移的筛查，解决了这些缺口。本荟萃分析专门评估自动化PTA在儿科人群中的诊断准确性。
方法： 我们检索了截至2026年3月的PubMed、Scopus和Web of Science中的相关文章。两名独立评审员从所选研究中提取数据，包括基线信息、结局、用于测试的设备类型以及诊断准确性指标。所有数据分析均使用R版本4.4.1进行。
结果： 在去除1186条重复记录后，筛选了2703条记录，最终纳入12项研究。在双变量模型中，自动化PTA的合并灵敏度为0.745（95% CI，0.620-0.840），特异度为0.882（95% CI，0.785-0.939），诊断比值比为24.667，曲线下面积为0.878。在单变量分析中，合并灵敏度和特异度分别为0.78和0.91。在各单项研究中，灵敏度范围为0.28至1.00，特异度范围为0.58至1.00。
结论： 自动化PTA在儿科人群中显示出高特异度但中等灵敏度。它可能作为初始听力筛查或分诊工具有用，特别是在配合的学龄儿童和资源有限的环境中，但不应取代全面的诊断性测听。在7岁以下儿童中表现不太一致，并随环境噪声、硬件、校准和测试方案而变化。

英文摘要

BACKGROUND: Childhood hearing loss severely delays the normal development of children. While traditional pure-tone audiometry (PTA) is the gold standard, it faces logistical barriers, specialist shortages, and high costs. Automated, smartphone-based testing addresses these gaps by enabling remote, task-shifted screening by non-specialists. This meta-analysis evaluates the diagnostic accuracy of automated PTA specifically within pediatric populations.
METHODS: We searched for relevant articles up to March 2026 from PubMed, Scopus, and Web of Science. Two independent reviewers extracted data from the selected studies, including baseline information, outcomes, type of device used for testing, and diagnostic accuracy metrics. All data analyses were performed using R version 4.4.1.
RESULTS: After removal of 1186 duplicates, 2703 records were screened and 12 studies were included. In the bivariate model, automated PTA demonstrated a pooled sensitivity of 0.745 (95% CI, 0.620-0.840), specificity of 0.882 (95% CI, 0.785-0.939), diagnostic odds ratio of 24.667, and area under the curve of 0.878. In the univariate analyses, pooled sensitivity and specificity were 0.78 and 0.91, respectively. Across individual studies, sensitivity ranged from 0.28 to 1.00 and specificity ranged from 0.58 to 1.00.
CONCLUSION: Automated PTA showed high specificity but moderate sensitivity in pediatric populations. It may be useful as an initial hearing-screening or triage tool, particularly in cooperative school-aged children and resource-limited settings, but it should not replace comprehensive diagnostic audiometry. Performance was less consistent in children younger than 7 years and varied with ambient noise, hardware, calibration, and testing protocol.